August 1968

Repair of Postinfarction Interventricular Septal Rupture

Author Affiliations

Durham, NC

From the departments of medicine (division of cardiology) (Drs. Dunaway and Greenfield) and surgery (Dr. Dillon). Durham Veterans Administration Hospital, and Duke University Medical Center, Durham, NC. Dr. Greenfield holds a Career Development Award from the Public Health Service.

Arch Intern Med. 1968;122(2):147-149. doi:10.1001/archinte.1968.00300070051009

Myocardial to occur in approximately 10% of people dying of myocardial infarction, and of these, 12% are associated with perforation of the interventricular septum.1,2 There are more than 250 cases of septal rupture described in the literature; however, less than 15% of these patients have survived more than two months after perforation.3 To date approximately 20 patients have been treated surgically.4-6 Although the mortality is quite high, earlier and more frequent surgical intervention has been suggested to improve the prognosis.

The following report documents the successful repair of a ventricular septal defect which occurred during the course of an acute myocardial infarction. The clinical manifestations and present criteria for management of these patients are reviewed.

Patient Summary  A 48-year-old aircraft mechanic was admitted to a nearby hospital on May 8, 1967, following two to three hours of severe chest pain, breathlessness, and diaphoresis. He had an 18-year

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